What Is The Evidence That Xylitol Chewing Gum Decreases Cariogenic Bacteria Population In College-Aged Students?

Dental caries represent the most widespread disease in humans with 91% of United States' adults aged 20-64 experiencing at least one cavity in a permanent tooth (CDC). Xylitol, a five carbon sugar polyol, is an FDA approved sweetener used as a sugar substitute in chewing gum. Xylitol inhibits S. mutans growth and decreases adhesion of plaque to teeth when chewed in gum.

Purpose. To determine if xylitol chewing gum decreases cariogenic bacteria in college-aged students. The importance of this work is to investigate the potential of xylitol chewing gum as a preventative measure against caries.

Methods. Institutional Review Board Approval was received for this cross-sectional research study. Education majors aged 18-22 years old (N=30) were recruited and completed informed consents. The World Health Organization: Oral Health Questionnaire for Adults survey was completed to assess oral health practices of subjects. Participants were randomly assigned to the xylitol, sorbitol, or control group with ten subjects in each group. The CariScreen Caries Susceptibility Meter was used to determine cariogenic bacteria population via ATP bioluminescence. Light intensity revealed through ATP bioluminescence is equivalent to ATP concentration and cariogenic bacteria content within the mouth. Baseline ATP measurements were taken with the CariScreen Caries Susceptibility Meter. Students chewed gum for twenty minutes for ten days excluding one weekend. ATP measurements were collected following twenty minutes of chewing gum on day ten. A paired t-test was used to compare changes within treatment groups. The SAS system was utilized to run an ANOVA to test for significant differences between treatment groups.

Results. The xylitol chewing gum group decreased 30% from a 2436 ± 2638 bacterial count at baseline to a 1697 ± 1963 bacterial count after ten days (p=0.094). While the sorbitol chewing gum group decreased 20% from a 1557 ± 1845 bacterial count at baseline to a 1244 ± 1673 bacterial count after ten days (p=0.69). Individuals in the control group increased 29% from a 1516 ± 1689 bacterial count at baseline to a 1960 ± 1995 bacterial count after ten days (p=0.29). A score under 1500 indicates a healthy mouth while a score higher than 1500 signifies heightened risk of caries development.

Conclusions. Individuals in the xylitol group experienced the greatest attenuation of cariogenic bacteria but lacked statistical significance. The sorbitol group also decreased in cariogenic bacteria but not to the extent of the xylitol group. Chewing gum with sugar substitutes like xylitol or sorbitol can decrease cariogenic bacteria population.

Jake Wagner presenting at the Minnesota Academy of Nutrition and Dietetics, May 1, 2016

Jake Wagner at the Nutrition Department Poster Competition

What Is The Evidence That Xylitol Chewing Gum Decreases Cariogenic Bacteria Population In College-Aged Students?

Research Advisor:Emily Heying, PhD